Salivary Cortisol and Risk Factors in Mothers of Low Socioeconomic-status

Objectives: Low socioeconomic-status (SES) is associated with increased risk of coronary disease, dental caries and immune-related diseases. Stress is known to affect immune function and to increase disease susceptibility. The purpose of this study was to describe biochemical measures of stress and oral health indicators in a population of low SES mothers. Methods: Forty-eight mothers attending a Community Health Center Women, Infants, and Children Clinic were enrolled in this study. Demographic data (age, marital status, and number of children) were recorded. Stimulated salivary samples were collected and analyzed with commercially available kits for numbers of Mutans Streptococci (MS) and Lactobacilli (LB) (CRT bacteria^®, Ivoclar Vivadent) and levels of the stress hormone cortisol (EIA immunoassay). Results: One hundred percent of subjects had MS counts greater than 10⁵. LB counts greater than 10⁵ were present in 68%. Twenty-seven percent of mothers had cortisol levels greater than 1ug/dl. Mothers with one child were 3.3 times more likely to have elevated cortisol than mothers with 2 or more children (p=0.02). Single mothers were 3.6 times more likely to have elevated cortisol levels (p=0.01). Increasing age appeared to be related to decreasing levels of cortisol, but this association disappeared when controlling for number of children and marital status. Unmarried women are 7.7 times more likely to have high cortisol levels when controlling for age and number of children (p=0.01). Mothers of two or more children are less likely to have high cortisol levels regardless of age or marital status. Conclusions: Stress and high oral bacterial levels may predispose the mothers, and possibly their offspring, to oral disease. These results indicate a pressing need to increase our understanding of the relationships between stress, oral bacterial amounts, and oral disease in this high-risk population.